When most people experience back pain between the shoulder blades, they associate their occurrence with various disorders of the spinal column, nerve roots, ligaments, intervertebral discs or the discs themselves.But it should be kept in mind that such painful sensations can be associated with other diseases of the chest organs - stomach, heart, respiratory system, mediastinal organs.
Such pain can be either acute, which increases quickly and passes quickly or increases significantly over time, or chronic, which torments the patient for a long time and requires an accurate diagnosis, because it can be a symptom of a serious pathology of any chest organ.Sometimes the pain between the shoulder blades can occur only after a sudden physical effort or after a long stay in a certain uncomfortable position.
It should be remembered that pain in the interscapular region is not a disease, but a symptom, and before using any ointments for back pain or injections, the real cause of their occurrence should be determined.When contacting the doctor, it is very important to describe all the smallest accompanying symptoms that accompany the pain, the time of its onset, the provoking factors of its intensification, because the doctor needs to help determine the direction of the examination and sometimes it is very difficult to make a correct diagnosis without accurate information about the nature of the pain.
Very often, untimely identification of the true cause of pain between the shoulder blades forces a person to undergo numerous expensive and time-consuming examinations, use various treatment options, which are sometimes inadequately prescribed and therefore do not bring the desired result.Therefore, it is very important that the patient himself knows about the possible list of diseases characterized by this pain syndrome.
Pain caused by pathologies of the spinal column
We will not dwell on such obvious causes as bruises, injuries, dislocations and fractures of the vertebrae, but will consider other possible causes of such back pain.
Intervertebral hernia
It should be known that a vertebral hernia in the thoracic spine is a very rare phenomenon, because this part of the spine does not bear such an increased load as the cervical and lumbar parts.In order to diagnose or rule out this pathology, a neurologist or osteopath refers the patient to an MRI or CT scan.Changes in the intervertebral hernia occur due to the fact that the fibrous ring - the outer part of the intervertebral disc begins to protrude from the tear, while the distance between the vertebrae decreases and the nerve roots are compressed.That is, the annulus fibrosus ruptures and the nucleus pulposus (the shock absorber in the center of the disc) begins to protrude into it.
If such a hernia is detected, doctors prescribe NSAIDs (anti-inflammatory drugs), physiotherapy, exercise therapy, reflexology, and in more severe cases, surgery is indicated.The difference between such pain in intervertebral hernia of the thoracic spine from other pathologies is that it is localized only in one place, and the pain can also radiate to the chest, which can resemble symptoms of lung or heart dysfunction.If an intervertebral hernia is not treated for a long time, curvature of the spine, paraparesis of the lower extremities, pelvic organ dysfunction and chronic pain syndrome may occur.
Overexertion combined with hypothermia of the back muscles
Back muscle strain can also cause pain in the shoulder blade area;this is not considered a disease, but with frequent excessive loads, heavy lifting, prolonged sitting or monotonous position, the risk of developing osteochondrosis, scoliosis and intervertebral hernias increases.Very often such pain affects people whose work requires them to be in the same position for several hours a day - these are seamstresses, drivers, office workers, surgeons.
Sometimes, when combining such a profession and air conditioning, hypothermia can occur, the so-called.lumbago, when the pain becomes more intense and requires the prescription of NSAIDs (non-steroidal anti-inflammatory drugs), the use of heating, distracting ointments, massage, etc.
To prevent such complications, you should avoid drafts, lead a maximally active lifestyle, practice yoga, Bodyflex, therapeutic exercises and go through a course of professional massage every six months.
Tuberculosis of the spine
Today, it seems that many doctors "forget" about this disease and anti-tuberculosis services in the country for some reason fall into decline, but almost 90% of the population is infected with Mycobacterium tuberculosis since childhood.If a person has sustained an injury, especially a back or joint, or simply has a severe cold, with a severely weakened immune system, a tuberculous focus often appears at the site of the injury, which cannot always be recognized in time even on an X-ray due to specific signs.
Often, in such cases, the diagnosis is made only when the person is already exhausted from terrible pain and has a number of complications.With this disease, a person can feel very strong, burning pains between the shoulder blades;patients describe it as twisting or drilling in one point of the spine, and also when the focus is localized in the thoracic spine, the pain radiates to the chest, where burning, heat and pain are felt.
Tuberculosis of the spine is a very insidious disease, and when it occurs in parts of the spine, the patient does not always have lung lesions;it can be an independent focus of tuberculosis infection in any part of the spine.People are used to the idea that tuberculosis is a disease that affects only the lower social strata of the population and is localized, as a rule, only in the lungs.This is a big misconception!
When the body's defense power is weakened, Koch's bacillus, which is present in almost every person's body, is activated in the weakest organs and begins a slow inflammatory process;these can be kidneys, lymph nodes, fallopian tubes in women, prostate or testicles in men, or individual vertebrae in the spine or joints in the limbs.
Scoliosis
According to statistics, almost 50% of the population has various degrees of scoliosis development - curvature, twisting of the spinal column, and most often it is the thoracic spine in combination with the cervical or lumbar spine.And since the ribs are connected to the thoracic regions, the shape of the chest also changes.There are several reasons for its development - these are congenital pathologies of ligaments, bones, as well as acquired - intense physical overload, sedentary office work or, for schoolchildren, sitting at a desk.
A surgeon, neurologist, orthopedist or osteopath can make a similar diagnosis with lateral and direct X-rays of the chest.Therapy of such a pathology must be very intensive and long-term - it includes massage, wearing a special corset and therapeutic exercises.In scoliosis, the leading symptom is pain in the back between the shoulder blades, and it also has the following symptoms:
- In the early stages, the curvature may be visually subtle, but as the scoliosis progresses, when the patient is examined from behind, the curvature becomes noticeable.
- With scoliosis, there is increased fatigue of the back muscles
- The position of the shoulders and arms can be at different heights
- The pain that torments the patient in the chest is often localized on one side
- Pain between the shoulder blades can be intermittent due to severe overexertion or prolonged standing or sitting, or it can be constant.
Osteochondrosis
Since the primary stages of osteochondrosis are found today even in ten-year-old children, this pathology can rightly be called the scourge of the modern city dweller.In recent times, this disease was considered a disease of older people, but modern life, an unhealthy, sedentary lifestyle leads to the early development of dystrophic changes in the joints and spine.The cause of back pain is an inflammatory process that develops in the surrounding tissues around the damaged vertebrae, as well as due to pinching of nerve roots.The following symptoms are characteristic of osteochondrosis:
- Constant, painful back pain, aggravated by sneezing, coughing, sudden changes in body position and physical activity
- When you straighten your shoulders, you may hear a grinding noise between your shoulder blades
- Chest pain can be described as feeling like a stake
- Reduced mobility of the ribs leads to difficulty breathing, and the person begins to breathe through the stomach.
- Movements in the hands are limited, weakness, tingling or numbness is felt in the hands.
Intercostal neuralgia
Intercostal neuralgia usually torments a person with pain in one side of the chest, but in rare cases it can also be in the area of the shoulder blades.This happens in situations where there is compression of nerve roots in the thoracic region due to excessive stress, hypothermia, injury, infectious diseases or osteochondrosis of the thoracic region.
In case of intercostal neuralgia, the symptoms and pain are intensified by pressure on the chest, when coughing and can bother the patient day and night.Since the pain due to osteochondrosis, scoliosis and intercostal neuralgia is very difficult to distinguish, qualified orthopedists, neurologists, osteopaths and surgeons should be contacted to clarify the diagnosis.
Spondyloarthrosis
This disease is very similar to osteochondrosis, in terms of the nature of the pain, the factors that increase it with load and changes in body position.It is also chronic in nature, with periods of exacerbations and remissions.Spondyloarthrosis can be distinguished from osteochondrosis only with the help of X-rays, MRI or CT.In this disease, the cartilage is destroyed and replaced by bone tissue, so bone protrusions can be found on the vertebra.
Myositis of the back muscles
After any hypothermia, acute respiratory viral infection, flu, muscle strain or back injury, inflammation in the muscle tissue - myositis - can occur.Like any disease, it can be acute or chronic.The pain can be in any part of the spine;it is painful in nature and is intensified by palpation, movement and physical activity.This is not a dangerous condition, and the use of warming and pain-relieving ointments for back pain usually helps.
Diseases of internal organs
As we have already said, pain in the area of the shoulder blades on the back is not always a sign of spinal disease;Almost all diseases of mediastinal organs, heart, stomach, pancreas and gall bladder can contribute to back pain.In our time of oncological tension, when cancer spares neither children nor adults, the development of tumors of the mediastinal organs, stomach and lungs can also manifest as pain in the area of the shoulder blades.
Diseases of the cardiovascular system
Coronary heart disease, myocardial infarction, angina pectoris are diseases that can also cause such pain.For angina pectoris.for example, the pain never lasts more than 5 minutes, and when nitroglycerin is taken, it usually goes away immediately.However, in the case of an acute attack, if severe pain lasts longer than 5 minutes, blood pressure drops, cold sweat appears or the skin turns pale, you should immediately call an ambulance.
Diseases of the gastrointestinal tract
Stomach ulcer, pancreatitis, cholecystitis are three diseases that can also be responsible for the appearance of pain in the thoracic region, both in front and behind.Also, the development of stomach and pancreatic cancer can cause such sensations.
Diseases of the respiratory system
If, in addition to back pain, the patient suffers from cough, an increase in body temperature, even slightly, the cause may be pulmonary pathologies.Usually, diseases such as pneumonia or pleurisy are preceded by hypothermia, acute respiratory viral infections and influenza.Recently, cases of developing atypical forms of pneumonia are becoming more common, when pneumonia is caused by pathogens such as mycoplasma or chlamydia, is not accompanied by a very high temperature, but can occur against a background of low temperature, and back pain can appear on the right or left side, when breathing intensifies.The main criterion for distinguishing lung pathology from other causes is the presence of fever, even if not high, and cough.
Other diseases
- Osteoporosis with fractures of the vertebral bodies, for example, on the background of long-term use of steroid hormones or a drop in estrogen in postmenopausal women.
- Vertebral metastases from stomach cancer, for example, can also cause pain
- Spontaneous fractures due to irrational loads.
- Ankylosing spondylitis (Bechterew's disease) is a systemic disease.It affects men more often, in whom, against the background of inflammation, the vertebrae are affected and the ligaments become ossified.As a result, the spine becomes inflexible and radiographically described as a bamboo stick.